HomeMy WebLinkAboutApplicationGadteld County
Community Development Department
108 8th Street, Suite 401
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BUILDING PERMIT
APPTICATION
WPE OF CONSTRUCTION
Commercial/Multi-Fa mily Demolition
Manufactured Home (Single or Multi-Level)
<.Residential (SF, Duplex or Townhome)Reroof
Accessory Dwelling Unit (ADU)- MAXIMUM SIZE OF 1;200 SQUARE FEET
INVOLVED PARTIES
Property Owner:
Mailing Address:
Email Address:
Phone:
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t
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CO EI
PhoneContractor:
Mailing Address:
Email Address:
tn¿,étr>t4J,o Phone:470
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Arch¡tect
Mailing Address:
Email Address:
,'-
¿?r9 Phone: IqTqI1,
c)o
lúl 6n
Email Address:
Engineer:
Mailing
Phone
Email Address:
Manufactured Home lnstaller:
Mailing Address:
Owne/s Valuation of Work: S Property Size (Sq. Ft. or Acres)
PROJECT DETAIIS
t u*tl-u*{,b¡vDescribe Work:
-rgbJob Address:
Height:
A/val
Asselsof',s ¿.1Parcgl Number;
Sq. Ft. of Building:S of Floors:
:t-ot qÀ slo.tSub. -
X Remodel/Alteration AdditionClass of Work:New
Garage:Attached Detached
5
PROJECT DETAILS CONTINUED
Septic:SWTS Community
Type of Heat:Natural Gac Propane Electrlc ftther
Driveway
Permit:
Exempt Permit #:
_N9r!çE
Authoritv. This application for a Building Permit must be signed by the Owner of the property, described above,
or an authorized agent. lf the signature below is not that of the Owner, a separate letter of authority, signed by
the Owner, must be provided with this Application.
Legal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
purposes of inspections by the Building Division.
Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County OWTS Permit,
(3) another permit required for use on the property identified above, e.g. State or County Highway/ Road Access
or a State Wastewater Discharge Permit.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days
of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION
lherebycertifythatlhavereadthisApplicationandthattheinformationcontainedaboveistrueandcorrect. I
understand that the Building Division accepts the Application, along with the plans and specifications and other data
submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness
of the submittals and approval of this Application, a Building Permit will be issued granting permission to me, as
Owner, to construct the structure(s) and facilities detailed on the submittals reviewed by the Building Division. ln
consideration of the issuance of the Building Permit, I agree that I and my agents will comply with provisions of any
federal, state, or local law regulating the work and the Garfield County Building Code, OWTS regulations and
applicable land use regulatrons (county Regulatron(s)). All County development requ¡r¡ng a permit, except for
residential uses, are subject to Article 7 of the Land Use and Development Code. I acknowledge that the Building
Permit may be suspended or revoked, upon notÌce from the County, if the location, construction or use of the
çtru¡trrrelcì end fa.il¡tvliêcì deccrihed ahove. are not in comnliance with Côuntv Resulationlsl or anv other
applicable law.
I hereby grant permission to the Building Division to enter the property, described above, to inspect the work. I
further acknowledge that the issuance of the Building Permit does not prevent the Building Official from; (1) requ¡ring
the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction or use of the
structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law. Review of this
Application, including submittals, and inspections of the work by the Building Division do not constitute an
acceptanceof responsibilityorliabilitybytheCountyoferrors,omissions,ordiscrepancies. AstheOwner, I
acknowledge that responsibility for compliance with federal, state and local laws and County Regulations rest w¡th
me and my authorized agents, including without limitation my architect designer, engineer and/ or builder.
I hereby acknowledge that I have read and understand the Notice and Ccrtification above, as well as, have
provid the required information which is correct and accurate to
\
Owner Print and Sign
the best oJ my knowledge.
¡t/ø¡/.s
Date
OFFICIAT USE ONIY 3
,9ee â#a ØN>/Special Conditions:
Plan Check Fee:IÙzq.'lz-Permit Fee: ¡ p
16q2.'I?Manu. Home Fee:Misc. Fees:
fr\tr sßD ëtsqß
Adiusted Valuatioru ,,
Ioø-172.ø1
OWTS No:f,æT-Ílr#'"'l¡iå2g.at Fees Paid:\oâs.tlâ "îlä'ôi",'q,s BP No:
KtrË-ßt{Sß"const.rtlþU zoninc:q¿rr4.0Setbåcks:TL occGroup: lRC
BUITDING / PTANNING DIVISION :úd,;rØ,
Signed Approval Date
l-3-Zozt
Gørfteld Coeenty
BUILDING DEPARTMENT
108 E¡ghth Street, Suite 407, Glenwood Springt CO 87607
Tel: (970) 945-8272
PI.^AN REVIE CHE CKLI
Permit No:øL1tE-//-27- g/59
ST
Building lssues Pla n ni ng I Toning lssues
qærÈ Driveway Permit
UND
ØLAttach conditions
Grade/Topography 30%
h Residential Plan Review List
bdivision Plat Notes
Fire Department Review
Valuation Determination/ Fees
Red Line Plans/ StamPs/ Sticker
Property Line Setbacks
35 ft. Stream Setbacks
Flood Plain
Building Height
Zoning Sign-Off
Grade/ TopograPhY 40%
Planning lssues
ision Plat
Road rmpact Fees 1BD ë |1578
Engineered Foundaticn
?îoþ51
Ito,u, ,nole+
Application Signed
ergy Compliance Path/Pla n Received
Plan Reviewer to Sign APPlication
Parcell Schedule No.
Soils Report
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